電子病歷推動現況及檢討建言

The Status Quo of Taiwan EHR Promotion, Criticism, and Recommendations

楊沛墩(Pei-Tun Yang) ； 陳彥臣(Yen-Chen Chen) ； 黃援傑(Yuen-Chueh Hwang)

《病歷資訊管理》 10卷2期 (2011/12) Pp. 1-11

https://doi.org/10.29741/JMHIM.201112.0001

摘要

行政院衛生署「加速辦理智慧醫療照護計畫」新增之「加速醫療院所實施電子病歷系統計畫（民國99至101年）」為現階段電子病歷推動之政策依據，此計畫向下委託台灣護理資訊學會成立電子病歷專案辦公室成為推動的專責幕僚單位，衛生署並委聘專家學者成立電子病歷發展會並下設臨床組、技術及標準組、病歷及病人安全組及企劃評核組等4個工作小組，負責電子病歷推動之政策方向及執行策略的討論與審議。推動的具體成果包括99年度各級醫院宣告實施電子病歷並向當地衛生局報備計有219家；通過電子病歷檢查計有142家；99年度已通過電子病歷跨院交換互通查驗之各級醫院合計133家，其中計21家／4類已實施部份病歷單張無紙化，足見政府推動電子病歷已具初步成果。然因補助經費縮減、醫院評鑑及健保給付配套不夠周延等因素，恐造成後續年度推動之困難，也是影響政府推動順遂與否之重要關鍵。為此，檢討並提出電子病歷推動過程之激勵辦法、強化電子病歷相關技術標準與規範教育訓練、研訂醫療資訊隱私專法的可能性及成立電子病歷標準常設專責管理單位等4大項目建言，希能對未來推動規劃與執行有所助益。

關鍵字

電子病歷

並列摘要

”Project (in 2010-2012) to Accelerate the Establishment of EHR System in Medical Institutions,” a new addition to the existing ”Accelerating Intelligent Healthcare Program” of Taiwan Department of Health (DOH) happens to be the policy basis in the current stage. Taiwan Society of Nursing Informatics was entrusted in the project to establish a project management office dedicated for EHR promotion. Besides, DOH also commissioned experts and scholars to set up a ”Committee of EHR Development.” Under the Committee there are four working groups, namely clinical group, technology and standards group, medical records and patient safety group, and assessment planning group to be in charge of policy direction steering and implementation strategy discussion and reviews of EHR promotion. Concrete achievements attained so far are as follows: 219 hospitals announced the implementation of adopting electronic medical record (EMR) and reported to the local health bureau in 2010, 142 hospitals passed the EMR check; 133 hospitals of various levels also passed an interinstitutional EHR exchange inspection in the same year, among which 21 hospitals in 4 categories implemented in part some paperless medical records. These preliminary results are adequate to prove that the government was successful in EHR promotion. However, recent reduced government funding, hospital accreditation, lack of adequate and appropriate supplementary measures to assure justified distribution of National Health Insurance benefits, and other factors could lead to unexpected difficulties to EHR promotion in the following years. And these factors are also the key to decide the utmost outcomes the government program. To this end, we reviewed the progress of the EHR program and made remedial recommendations for the following four major problems: 1. Lack of incentive motivation; 2. Short of educational trainings to enhance relevant EHR technical standards and specifications; 3. Needs of special laws governing privacy of medical information; and 4. Lack of a dedicated management unit for EHR standards. We hope these recommendations will be helpful to the planning and execution of the program in the future.

並列關鍵字

Electronic Health Record